药物疗法对恶性肿瘤患者糖化血红蛋白和空腹血糖的影响

Effect of chemotherapy on fasting blood glucose and glycosylated hemoglobin in malignant tumor patients

目的探讨药物疗法对恶性肿瘤患者糖化血红蛋白(Hb A1c)和空腹血糖(FBG)的影响。方法将2012年2月至2014年2月收治的63例恶性肿瘤行化疗患者作为研究对象,观察患者单次化疗前后、多次化疗前后的Hb A1c和FBG水平,同时分析血糖、胰岛素水平及胰岛功能与疗程的相关性。结果单次化疗后患者的FBG、空腹C-肽及胰岛素水平均明显高于化疗前(P<0.05),但单次化疗前后Hb A1c水平的差异无统计学意义(P>0.05)。多次化疗后患者的FBG、空腹C-肽、Hb A1c及空腹胰岛素水平均高于化疗前,差异有统计学意义(P<0.05)。不同疗程胰岛素抵抗指数(HOMA-IR)、Hb A1c及胰岛素水平与化疗次数呈正相关(P<0.05),而C-肽、FBG及胰岛素分泌指数(HOMA-β)与化疗次数无相关性(P>0.05)。结论化疗会影响恶性肿瘤患者的血糖代谢指标及胰岛功能,长期化疗则会降低胰岛功能并诱发糖尿病。

Objective To explore the effect of chemotherapy on glycosylated hemoglobin（Hb A1c）and fasting blood glucose（FBG） in malignant tumor patients.Methods Total of 63 cases of patients with malignant tumor were selected as the research object in the First People’s Hospital of Xi’ning City,this study retrospectively analyzed the blood glucose levels and insulin function before and during chemotherapy in 63 patients,and analyzed the correlation between the levels of blood glucose and the number of chemotherapy.Results After a single dose of chemotherapy,the levels of FBG,C-peptide and insulin in these patients were significantly higher than that before chemotherapy（P 〈 0.05）,however,the levels of Hb A1 c had no significant difference between before chemotherapy and after chemotherapy（P 〉 0.05）.Many times after chemotherapy,the levels of FBG,Hb A1 c,C-peptide and insulin in these patients were remarkablely higher than before chemotherapy（P 〈 0.05）.Insulin resistance index,Hb A1 c and insulin levels were positively correlated with the number of chemotherapy（P 〈 0.05）,however,insulin secretion function index,C-peptide and FBG had no correlation with the number of chemotherapy（P 〉 0.05）.Conclusion Chemotherapy significantly influence the blood glucose metabolism and insulin function of patients with malignant tumor,and long-term chemotherapy could reduce islet function and induce diabetes.